There's nothing quite as adorable as a cuddly, snuggly, purring fluffball, but only a mother could love the smell of a cat's breath. Post-meal seafood supreme and kitty stew halitosis is the norm. And felines are notorious for their bacteria-laden mouths, which even on the best of days beg for a kitty breath mint — if only there were such a thing.
But while your cat's normal breath may not be exactly perfect, it should not be overly strong or offensive. And keep in mind, the smell of her breath may alert you to several health problems. For example, a cat's breath should never smell sweet, ammonia-like, bile-like, or even have an odor like human morning breath. Respectively, these are signs of diabetes mellitus, kidney disease, liver disease, and gum disease.
And if your cat's breath smells like nail polish remover, she may be experiencing diabetic ketoacidosis, also known as DKA. This serious metabolic emergency is caused by a lack of insulin where the body produces ketones including acetone, the key component in many nail polish removers. It's critical to seek veterinary care immediately since treatment must be started as soon as possible.
What is diabetes mellitus?
Uncomplicated diabetes mellitus is a serious medical condition in cats that is characterized by the cat not being able to control his blood sugar levels due to problems with insulin production or function. Cats usually suffer from non-insulin-dependent diabetes that is comparable to type II diabetes in human adults where there is a high or normal initial blood insulin level but the body is resistant to the function of insulin. In cats, it is primarily treated with insulin, and also regulated with diet, and sometimes other medications.
Diabetes symptoms include excessive urination, thirst, and a ravenous appetite accompanied by weight loss. As mentioned, there may also be a distinctly sweet smell to the cat's breath. But what's going on inside the diabetic cat's body is complex and dangerous. It all revolves around glucose, the main energy source that the body cells need to operate efficiently.
When the cat eats, his digestive system breaks the food down into different parts, including glucose, which then enters the bloodstream. Meanwhile, the pancreas is busy manufacturing insulin, the vital key that facilitates the cells absorption of the essential glucose.
But when the body is resistant to insulin or insulin levels are too low, glucose stays in the bloodstream, unable to enter the cells where it's needed. When the cells can't utilize glucose, they send a message to the body that it's starving, ergo the ravenous appetite. High levels of glucose thus remain in the bloodstream, which makes the cat urinate excessively, then drink excessively to make up for the loss of water.
This vicious cycle wreaks havoc on the cat's body. Without treatment, the cells begin to utilize less desirable fuel sources such as fat and tons of fatty acids circulating through the blood stream is extremely harmful leading to kidney and liver damage, and even death.
What is diabetic ketoacidosis (DKA) and why does it make a cat's breath smell like nail polish remover?
When the signs of diabetes go unrecognized or undiagnosed for a long period, diabetic ketoacidosis may occur. Signs of ketosis are nausea, vomiting, and stomach pain. DKA also develops in cats being treated for diabetes when the prescribed insulin dose is suddenly insufficient for control, the action of the insulin is impaired, or the cat develops a resistance to insulin due to concurrent illness, drugs, or obesity.
Because glucose cannot be used when there's a lack of insulin, fats are instead broken down to provide energy. This process known as lipolysis is utilized by the body to mobilize stored fats and is accomplished via enzymes and water, or hydrolysis. As the fat breaks down, the liver turns the fat into ketones, molecular bodies that are a type of acid, which leads to ketosis resulting in anorexia, nausea, and lethargy as well as electrolyte imbalances. Acetone, the simplest and smallest of the three ketones is a spontaneously created side product of the ketone acetoacetate and common ingredient in nail polish removers. It imparts its fruity smelling odor to the breath of a cat suffering from DKA.
Treatment of DKA
When a cat goes into DKA, it is an emergency that requires veterinary treatment as soon as possible. The main objective of the aggressive therapy protocol is to lower the high levels of glucose in the blood and intense concentrations of ketones, as well as correct fluid deficits and achieve an acid-base balance and electrolyte balance. Further, your veterinarian will attempt to identify and correct the precipitating factors which may include inadequate insulin therapy or underlying medical conditions.
To accomplish these goals, vets use intravenous isotonic fluid therapy, for example, 0.9% saline, and administer an intravenous fast-acting insulin. During therapy, electrolyte concentrations and acid-base balance is measured and corrected.
Once the blood glucose is lowered and maintained between 11 and 14 mmol/L or 198 and 252 mg/dL for a minimum of four to 10 hours, insulin therapy administered subcutaneously with an intermediate-acting insulin can be initiated.
The good news
The good news is that diabetes mellitus is treatable, and DKA, if caught on time, can be successfully treated. But keep in mind that your cat's diabetes will require life-long attention and due to insulin injection schedules may restrict some of your activities. The disease may be temporary, permanent, variable, or remain stable throughout the diabetic cat's lifetime. With careful attention to insulin injection schedules and dosage requirements, and regular trips to your veterinarian to check glucose levels, diabetic ketoacidosis can be avoided and the diabetic cat can have an excellent quality of life.